Congenital Scoliosis Case 1

39 year old female, with progressive curvature status post posterior spinal fusion at age 6 for congenital scoliosis.

Patient History:

39-year-old female
Multiple hemivertebrae with a sharp angular curvature proximally and kyphosis, treated by in situ posterior spinal fusion at age 6.
The patient now has progressive adding on of the subadjacent thoracolumbar spine with severe rotation of the lumbar spine and multiple level anomalies including lumbosacral transitional vertebra.
She has a high left rib hump
The patients curve is increasing. This has been documented serially with 1996 to current films.
The patient has significant upper and lower back pain, which has been uncontrolled with conservative therapy.
The progressive nature of the scoliosis and junctional aspects of the previous surgery are the causative etiology.

Pre-op X-rays:

She has a significant T1 tilt with an oblique neck done and decompensation to the right. She has a compensatory right thoracolumbar elevated flank. She also has evidence 31° of decreas lumbar lordosis due to what appears to be a lumbosacral transitional vertebra.